Archive for ‘Ophthalmology’

Medgadgetrecently reported on the first successful use in patients of the Preceyes system for robotic vitroretinal surgery from Preceyes, a firm from Eindhoven, The Netherlands. We had the opportunity to ask Perry van Rijsingen, CEO of Preceyes some questions about the new technology and how the Preceyes team overcame some of the challenges medtech start-ups face.

Tom Peach, Medgadget: To start, please tell us about the Preceyes system and the team behind it.

Perry van Rijsingen, CEO of Preceyes: The Preceyes system focuses on robotic assistance for vitreoretinal (VR) surgeons. Our system is designed to provide assistance so that the surgeon can work with higher accuracy and precision, while at the same time improving on dexterity. The system is expected to improve treatment outcomes for patients and increase procedural safety, while the higher degree of automation inherent to robotics is also expected to improve clinical workflows and bring down costs.

Preceyes began as early as 2007 as a research collaboration between Marc de Smet, in those days professor and VR surgeon working at the Academic Medical Center in Amsterdam and Maarten Steinbuch, distinguished Robotics professor, at the Eindhoven University of Technology. A lot of our technical development was driven by the unique knowledge base in and around Eindhoven, with its university and some of the world’s leading ultra-fine precision mechatronic instrumentation companies. We incorporated in 2011 and our first sale happened in 2016 to NightstaRx—a British biopharma company working on gene therapy for several retinal diseases.

Medgadget: What is unique about the Preceyes system?

Perry van Rijsingen: The Preceyes robot is unique because of both its ultra-high-precision and ultra-high-dexterity. This is achieved by scaling down movements in the system, which dramatically increases precision by more than a factor of 10, while also filtering out any surgeon hand tremor. The instruments used in VR surgery are so fine that they often bend and deform when inserted into the eye by hand—the level of control in our system means this does not happen. The integration of the system with the conventional operating room is also very sophisticated, and the system can be used with the majority of operating tables.

Medgadget: What benefits does the Preceyes system offer to patients?

Perry van Rijsingen: Firstly there is patient access to surgery. The level of manual control and precision that these VR surgeons have is incredible, but it takes years and years of training to get to that level. Also, a VR surgeon can quickly reach an age where hand tremor and other inaccuracies can become a problem, often long before the normal retirement age. So being able to use robotics to take over some of the precision and dexterity allows us to train surgeons faster and extend the number of years they can work once trained. This is, of course, an even bigger issue in emerging economies, where there is currently a very significant shortage of VR surgeons. But, given that the incidence of VR diseases is expected to doubling in the next 15 years, there will also soon be a shortage of VR surgeons in developed economies as well.

The other benefit is the improved accuracy and precision of the surgery overall, which is expected to lead to dramatically improved patient safety and health outcomes. This is a pattern that is true for all robotic surgery. The ultra-high precision required in VR surgery would suggest that the gains for patients from robotic assistance could be even greater.

Finally, the technology opens up opportunities for totally new therapies, particularly gene and cell therapies, vein cannulation, and the possibility of sub-retinal implants. With the Preceyes system you can place a needle in the sub-retinal space with a 10 micrometer precision and keep it there for two or three minutes while you carefully inject a fluid—that is something that is just impossible manually.

Medgadget: What was the biggest challenge you faced in developing Preceyes?

Perry van Rijsingen: Looking back, the biggest challenge was also the biggest achievement, and that was talking to so many surgeons and people in the VR field—that is what really shaped the current system. It may not be the biggest technological hurdle that had to be overcome, but if you look at where many start-ups face their biggest challenge, it’s understanding and truly dealing with unmet medical needs, and that is where the end-user’s input is vital.

Medgadget: Preceyes is currently undergoing first-in-human trials, which is a development stage often never reached by device companies. What are the biggest challenges faced by a healthcare start-up in getting to the in-human phase and how are they best overcome?

Perry van Rijsingen: There needs to be real drive to get there from your clinical and industrial partners, and for that to be true, your solution really must be meeting an unmet need. It’s always risky to adopt the technology of a start-up, particularly in the medical space, so if you start a new business, you have to ask yourself—am I really offering a unique value proposition? If you don’t have a radically unique value proposition and the business model to deliver it in a sustainable way, it will be very difficult to get to the in-human stage. In Preceyes we have paid very close attention to fully addressing the unmet need aspect.

Medgadget: Prior to Preceyes you spent 10 years leading the Philips Healthcare Incubator Portfolio; what do you think was the most important lesson you learned in that role?

Perry van Rijsingen: I think the most striking thing was again the need for an offering to be sustainably unique. In reviewing new concept ideas from both within Philips and from external start-ups, I’d say we operated with about a 99% attrition rate. At that early stage of investing in an idea, you have to be extremely critical on a number of parameters, which leads to the second major lesson—and it’s not a nice word—but you have to learn to kill fast. At the end of the day, creating a radically new healthcare business is always very expensive and it becomes progressively more expensive. One needs to decide in an early phase, say within the first 6-12 months, if you want to go “all the way”, i.e. getting that venture to market and make it cash positive. If so, you have to have a very rigorous system of stage-gating during the entire process, and the early stage gates are very important.

Medgadget: You’re a very accomplished business leader who would undoubtedly be successful in many fields; what got you interested in the biomedical and medical devices world specifically?

Perry van Rijsingen: Healthcare has always attracted me: I find it fascinating, and it’s changing enormously all the time. The challenges are huge, and with more people living longer with chronic diseases, the affordability of healthcare in particular is becoming an enormous issue. But that’s the reason why I have always loved this business: because you get to help people and overcome massive challenges.

In Philips I also worked successfully in several other non-healthcare divisions, but, in the end, the fruits of your works in a healthcare business are really helping people to live better and longer lives. To me, that is tremendously satisfying, and I feel like I’ve been able to contribute to improving the lives of others. Many years from now, when I’m sitting with my grandchildren on my lap, and they ask me what I did with my life, that’s what my answer will be.

Video-article details new laser-activated bio-adhesive polymer

A new video-article in JoVE, Journal of Visualized Experiments, details the use of a new laser-activated bio-adhesive polymer. The chitosan-based polymer, SurgiLux, was developed by scientists at the University of New South Wales. Chitosan is a polymer derived from chitin, which is found in fungal cell walls or in exoskeletons of crustaceans and insects.This molecular component allows SurgiLux to form low energy bonds between the polymer and the desired tissue when it absorbs light. The technology may soon replace traditional sutures in the clinic.

For thousands of years, clinicians have been using sutures to close open wounds and help repair torn tissues. Dr. L. John Foster from the University of New South Wales explains that, “though sutures have a superior strength to SurgiLux, sutures are physically invasive and do not support tissue regeneration. SurgiLux is a thin film, so you do not end up with any physical invasion or further damage to the tissue, thus allowing more complete healing.” This is beneficial when repairing delicate tissues like neurons or blood vessels.

The SurgiLux polymer has two valuable properties: it can achieve a uniform seal when activated by a laser, and has antimicrobial properties attributable to the chitosan base. Together, these features prevent the wound from becoming infected and maintain a barrier between the tissue and its surroundings. A suture would require extensive bandaging to achieve the same results. The polymer is particularly useful for hard-to-operate tissues or organs, such as the eye. “We are exploring ophthalmology as a venue for SurgiLux in human patients. SurgiLux can be readily applied to the eye during surgery, and can seal the cornea in place during keratoplasty when sutures cannot,” tells Dr. Foster.

Dr. Foster and his team chose to publish in JoVE to expedite adoption of the technology. While the concept of SurgiLux has been previously published, this is the first demonstration of its application with the laser. “Many surgeons want to adopt it immediately. However, people don’t know how to use the lasers. JoVE can visually show that this is not a difficult system and that any group with a basic background in biochemistry can buy a laser and get to work testing SurgiLux.”

Omron electroTherapy TENS System for Pain Relief

LAKE FOREST, Ill., Sept. 18, 2012 /PRNewswire/ — Omron Healthcare, a leader in pain relief for more than 20 years, announced today a new electrotherapy solution for muscle and joint pain relief. The Omron electroTHERAPY Pain Relief unit (PM3030) is FDA cleared and now available to U.S. consumers without a prescription. Launched in conjunction with a new educational website, www.omronpainrelief.com, the pain solution is currently available at www.OmronWebstore.com and through several online retailers including, Amazon.com and Drugstore.com.

(Photo: http://photos.prnewswire.com/prnh/20120918/CG75739)

“As a pain management physician for 15 years, I’ve found electrotherapy to be a valuable pain management option,” said Dr. Rajive Adlaka, a board certified physician specializing in anesthesia and pain management. “One of the most important aspects of this therapy is that it’s 100 percent drug free. It essentially has no side effects and there’s no fear of addiction.”

Utilizing TENS (transcutaneous electrical nerve stimulation) technology, the same technology used by physical therapists for more than 30 years, the Omron electroTHERAPY device is easy to use and helps relieve pain wherever it is needed most. The pads for the Omron electroTHERAPY unit are placed near the site of the pain and safely deliver gentle, massage-like pulses to alleviate stiff, achy, or sore muscles and joints.

“There are as many as 100 million people in the U.S. with acute or chronic pain. Omron electroTHERAPY for Pain Relief may help alleviate their pain in as little as 15 minutes,” said Maureen Perou, senior product manager at Omron. “What’s different about this product is that it demystifies and simplifies a time-tested therapy. It’s like having a physical therapist by your side whenever you need it.”

Featuring three preset programs each with five levels of intensity, the simple controls allow for personalization according to the type of pain. This small, handy unit fits in your hand or pocket for use almost anywhere and includes two comfortable, Long Life pads that are good for up to 150 uses.

Suggested retail price for the device is $69.99. New Long Life replacement pads (set of 2) can be purchased for $19.99 at www.OmronWebstore.com. Currently available online, Omron electroTHERAPY will soon be in local drugstores across the country.

Omron Healthcare has been a global pain leader for more than 20 years, selling more than five million units worldwide since 2003. For more information, visit Omron’s new website at www.omronpainrelief.com.

About Omron Healthcare, Inc.

Omron Healthcare, Inc., is a leading manufacturer and distributor of personal wellness products. Omron’s market-leading products include home blood pressure monitors, fitness solutions, such as pedometers and heart rate monitors, and electrotherapy devices. In our connected and digital world, consumers’ want to accurately monitor and track certain aspects of their day-to-day health on- and offline. Omron products provide accurate health information that support positive lifestyle changes and can be shared with friends, family and other health professionals. For more information, visit www.omronhealthcare.com.

Omron electroTHERAPY Pain Relief is a simple, drug-free solution for relief of achy, stiff or sore muscle and joint pain. Available without a prescription, this easy-to-use TENS unit can help manage your pain in as little as 15 minutes exactly where you need it. It is one solution for multiple body pains.

Safe and effective, electroTHERAPY uses Transcutaneous Electrical Nerve Stimulation (TENS) technology to deliver gentle, massage-like pulses for on-the-spot pain relief. TENS therapy has been used by physical therapists and medical professionals for more than 30 years. Select the program that is right for your unique pain (arm, lower back or leg/foot) and adjust between five intensity levels.

Product Features

TENS TECHNOLOGY: Transcutaneous Electrical Nerve Stimulation (TENS) technology has been used by medical professionals such as physical therapists and chiropractors for more than 30 years

Omron Healthcare has released the new electroTHERAPY over-the-counter TENS (transcutaneous electrical nerve stimulation) system for temporary pain relief of muscles and joints.

The device can deliver three different preset programs at five levels of intensity that patients select between depending on the nature of their pain symptoms. Omron has setup a website to help people use the device and with positioning of the electrode pads for various common sources of pain.

Features from the product page:

TENS TECHNOLOGY: Transcutaneous Electrical Nerve Stimulation (TENS) technology has been used by medical professionals such as physical therapists and chiropractors for more than 30 years

Cook Medical’s New Otolaryngology/Head and Neck Surgery Division and Products

WASHINGTON–(BUSINESS WIRE)–Cook Medical, a world leader in minimally invasive medical device technology, has launched its new Otolaryngology/Head and Neck Surgery (OHNS) clinical division to bring the benefits of the company’s devices for non-surgical procedures to a new group of physicians and the patients they treat.

“Cook Medical has a solid and lengthy track record in innovating minimally invasive technologies, and has the ability to help transform the way we may approach such things as reducing post-tonsillectomy pain or advancing our understanding of the treatment of sinusitis.”

Recognizing the need for specialized minimally invasive devices in otolaryngology, Cook OHNS is researching and developing alternatives to open surgery for treating conditions across several traditional ear, nose and throat (ENT) specialties.

The division’s initial six practice areas of focus are soft tissue repair, salivary gland disease, chronic sinusitis, vocal cord paralysis, obstructive sleep apnea, and interventional airway and esophageal procedures. There is great potential within these six areas to bring new treatment options, many of which are alternatives to open surgery, to millions of patients in the U.S. and globally, Cook officials said.

“We started Cook OHNS to pioneer ways to provide patients with diseases affecting the head and neck with less traumatic alternatives to surgeries. As we met with physicians, we heard loud and clear that they saw many opportunities for minimally invasive medical devices in this field,” said Thomas Cherry, global leader for Cook Medical’s OHNS division. “At our core, we’ve always solved problems for clinicians over Cook’s entire history. So now, Cook OHNS is taking proven interventional tools and techniques and applying them to the emerging science of minimally invasive otolaryngology and head and neck surgery.”

Cook will showcase the following products at AAO-HNS:

Salivary Duct Access Products: Intended to reduce trauma for the patient and reduce the need for open surgery, the tools in this product line help physicians perform minimally invasive sialendoscopy procedures. The devices, which include a wire guide, dilator set, Kolenda introducer sheath and the NGage® and NCircle® salivary stone extractors, help enable physicians to gain access to stones and remove them in the physician’s office without surgery.

Hercules 3 Stage Esophageal Balloon: The Hercules 3 Stage Esophageal Balloon is designed to treat abnormal narrowing of the digestive tract that can interfere with eating, swallowing and digestion. The device is made with proprietary P.E.T. Flex™ technology, a material that optimally combines the high tensile strength and flexibility necessary for a strong balloon that inflates to three distinct and increasing diameters.

Chiba EchoTip Biopsy Needle: The high-visibility EchoTip biopsy needle allows physicians to perform thyroid biopsy with a needle that can be easily seen under ultrasound. High visibility results in more accurate needle placement and reduces the number of needle passes needed to obtain a sufficient sample. The Chiba EchoTip biopsy needle design provides enhanced visualization of needle tip when used with ultrasonic imaging equipment to ensure a strong, hyperechoic reflection and clearly visible images.

“There is a definite need for true out-of-the-box thinking around minimally invasive medical technology for OHNS,” said Patrick Melder, M.D., of ENT Associates of North Georgia and a presenter at the AAO-HNS conference. “Cook Medical has a solid and lengthy track record in innovating minimally invasive technologies, and has the ability to help transform the way we may approach such things as reducing post-tonsillectomy pain or advancing our understanding of the treatment of sinusitis.”

“For months, Thomas Cherry kept saying we could help a large group of patients if we could make our products available to them, and he was right. He was doing what Cook has always done; listened to physicians, heard what they needed and given them the tools to treat patients in a better way,” explained Pete Yonkman, executive vice president of strategic business units for Cook Medical.

A global pioneer in medical breakthroughs, Cook Medical is committed to creating effective solutions that benefit millions of patients worldwide. Today, we combine medical devices, drugs, biologic grafts and cell therapies across more than 16,000 products serving 41 medical specialties. Founded in 1963 by a visionary who put patient needs and ethical business practices first, Cook is a family-owned company that has created more than 10,000 jobs worldwide. For more information, visit www.cookmedical.com. Follow Cook Medical on Twitter and LinkedIn.

WASHINGTON–(BUSINESS WIRE)–Cook Medical, a world leader in minimally invasive medical device technology, has launched its new Otolaryngology/Head and Neck Surgery (OHNS) clinical division to bring the benefits of the company’s devices for non-surgical procedures to a new group of physicians and the patients they treat.

“Cook Medical has a solid and lengthy track record in innovating minimally invasive technologies, and has the ability to help transform the way we may approach such things as reducing post-tonsillectomy pain or advancing our understanding of the treatment of sinusitis.”

Recognizing the need for specialized minimally invasive devices in otolaryngology, Cook OHNS is researching and developing alternatives to open surgery for treating conditions across several traditional ear, nose and throat (ENT) specialties.

The division’s initial six practice areas of focus are soft tissue repair, salivary gland disease, chronic sinusitis, vocal cord paralysis, obstructive sleep apnea, and interventional airway and esophageal procedures. There is great potential within these six areas to bring new treatment options, many of which are alternatives to open surgery, to millions of patients in the U.S. and globally, Cook officials said.

“We started Cook OHNS to pioneer ways to provide patients with diseases affecting the head and neck with less traumatic alternatives to surgeries. As we met with physicians, we heard loud and clear that they saw many opportunities for minimally invasive medical devices in this field,” said Thomas Cherry, global leader for Cook Medical’s OHNS division. “At our core, we’ve always solved problems for clinicians over Cook’s entire history. So now, Cook OHNS is taking proven interventional tools and techniques and applying them to the emerging science of minimally invasive otolaryngology and head and neck surgery.”

Cook will showcase the following products at AAO-HNS:

Salivary Duct Access Products: Intended to reduce trauma for the patient and reduce the need for open surgery, the tools in this product line help physicians perform minimally invasive sialendoscopy procedures. The devices, which include a wire guide, dilator set, Kolenda introducer sheath and the NGage® and NCircle® salivary stone extractors, help enable physicians to gain access to stones and remove them in the physician’s office without surgery.

Hercules 3 Stage Esophageal Balloon: The Hercules 3 Stage Esophageal Balloon is designed to treat abnormal narrowing of the digestive tract that can interfere with eating, swallowing and digestion. The device is made with proprietary P.E.T. Flex™ technology, a material that optimally combines the high tensile strength and flexibility necessary for a strong balloon that inflates to three distinct and increasing diameters.

Chiba EchoTip Biopsy Needle: The high-visibility EchoTip biopsy needle allows physicians to perform thyroid biopsy with a needle that can be easily seen under ultrasound. High visibility results in more accurate needle placement and reduces the number of needle passes needed to obtain a sufficient sample. The Chiba EchoTip biopsy needle design provides enhanced visualization of needle tip when used with ultrasonic imaging equipment to ensure a strong, hyperechoic reflection and clearly visible images.

“There is a definite need for true out-of-the-box thinking around minimally invasive medical technology for OHNS,” said Patrick Melder, M.D., of ENT Associates of North Georgia and a presenter at the AAO-HNS conference. “Cook Medical has a solid and lengthy track record in innovating minimally invasive technologies, and has the ability to help transform the way we may approach such things as reducing post-tonsillectomy pain or advancing our understanding of the treatment of sinusitis.”

“For months, Thomas Cherry kept saying we could help a large group of patients if we could make our products available to them, and he was right. He was doing what Cook has always done; listened to physicians, heard what they needed and given them the tools to treat patients in a better way,” explained Pete Yonkman, executive vice president of strategic business units for Cook Medical.

A global pioneer in medical breakthroughs, Cook Medical is committed to creating effective solutions that benefit millions of patients worldwide. Today, we combine medical devices, drugs, biologic grafts and cell therapies across more than 16,000 products serving 41 medical specialties. Founded in 1963 by a visionary who put patient needs and ethical business practices first, Cook is a family-owned company that has created more than 10,000 jobs worldwide. For more information, visit www.cookmedical.com. Follow Cook Medical on Twitter and LinkedIn.

Optogenetic Skeletal Muscle Cells Activated by Light

Scientists have been working with lab-grown muscle tissue for quite a while now, but the only way to trigger contractions has been electric stimulation. This requires wiring and electrodes that gently attach to tissue, and that complicates matters if you want to build something that’s powered by artificially created muscle cells.

Now researchers from MIT and the University of Pennsylvania used optogenetics to create engineered skeletal muscle cells that contract when illuminated by a 20-millisecond blue light beam. Previously cardiac cells were created using optogenetics, a technique that embeds genes that code for light reactive proteins, but the new development should be more useful in robotics and perhaps even in prostheses that will use light activated muscles made at a factory.

The light-sensitive muscle tissue exhibits a wide range of motions, which may enable highly articulated, flexible robots — a goal the group is now working toward. One potential robotic device may involve endoscopy, a procedure in which a camera is threaded through the body to illuminate tissue or organs. Asada [Harry Asada professor of engineering at MIT] says a robot made of light-sensitive muscle may be small and nimble enough to navigate tight spaces — even within the body’s vasculature. While it will be some time before such a device can be engineered, Asada says the group’s results are a promising start.

“We can put 10 degrees of freedom in a limited space, less than one millimeter,” Asada says. “There’s no actuator that can do that kind of job right now.”

Rashid Bashir, a professor of electrical and computer engineering and bioengineering at the University of Illinois at Urbana-Champaign, says the group’s light-activated muscle may have multiple applications in robotics, medical devices, navigation and locomotion. He says exploring these applications would mean the researchers would first have to address a few hurdles. “Development of ways to increase the forces of contraction and being able to scale up the size of the muscle fibers would be very useful for future applications,” Bashir says.

Many robotic designs take nature as their muse: sticking to walls like geckos, swimming through water like tuna, sprinting across terrain like cheetahs. Such designs borrow properties from nature, using engineered materials and hardware to mimic animals’ behavior.

Now, scientists at MIT and the University of Pennsylvania are taking more than inspiration from nature — they’re taking ingredients. The group has genetically engineered muscle cells to flex in response to light, and is using the light-sensitive tissue to build highly articulated robots. This “bio-integrated” approach, as they call it, may one day enable robotic animals that move with the strength and flexibility of their living counterparts.

The researchers’ approach will appear in the journal Lab on a Chip.

Harry Asada, the Ford Professor of Engineering in MIT’s Department of Mechanical Engineering, says the group’s design effectively blurs the boundary between nature and machines.

“With bio-inspired designs, biology is a metaphor, and robotics is the tool to make it happen,” says Asada, who is a co-author on the paper. “With bio-integrated designs, biology provides the materials, not just the metaphor. This is a new direction we’re pushing in biorobotics.”

Seeing the light

Asada and MIT postdoc Mahmut Selman Sakar collaborated with Roger Kamm, the Cecil and Ida Green Distinguished Professor of Biological and Mechanical Engineering, to develop the new approach. In deciding which bodily tissue to use in their robotic design, the researchers set upon skeletal muscle — a stronger, more powerful tissue than cardiac or smooth muscle. But unlike cardiac tissue, which beats involuntarily, skeletal muscles — those involved in running, walking and other physical motions — need external stimuli to flex.

Normally, neurons act to excite muscles, sending electrical impulses that cause a muscle to contract. In the lab, researchers have employed electrodes to stimulate muscle fibers with small amounts of current. But Asada says such a technique, while effective, is unwieldy. Moreover, he says, electrodes, along with their power supply, would likely bog down a small robot.

Instead, Asada and his colleagues looked to a relatively new field called optogenetics, invented in 2005 by MIT’s Ed Boyden and Karl Deisseroth from Stanford University, who genetically modified neurons to respond to short laser pulses. Since then, researchers have used the technique to stimulate cardiac cells to twitch.

Asada’s team looked for ways to do the same with skeletal muscle cells. The researchers cultured such cells, or myoblasts, genetically modifying them to express a light-activated protein. The group fused myoblasts into long muscle fibers, then shone 20-millisecond pulses of blue light into the dish. They found that the genetically altered fibers responded in spatially specific ways: Small beams of light shone on just one fiber caused only that fiber to contract, while larger beams covering multiple fibers stimulated all those fibers to contract.

A light workout

The group is the first to successfully stimulate skeletal muscle using light, providing a new “wireless” way to control muscles. Going a step further, Asada grew muscle fibers with a mixture of hydrogel to form a 3-D muscle tissue, and again stimulated the tissue with light — finding that the 3-D muscle responded in much the same way as individual muscle fibers, bending and twisting in areas exposed to beams of light.

The researchers tested the strength of the engineered tissue using a small micromechanical chip — designed by Christopher Chen at Penn — that contains multiple wells, each housing two flexible posts. The group attached muscle strips to each post, then stimulated the tissue with light. As the muscle contracts, it pulls the posts inward; because the stiffness of each post is known, the group can calculate the muscle’s force using each post’s bent angle.

Asada says the device also serves as a training center for engineered muscle, providing a workout of sorts to strengthen the tissue. “Like bedridden people, its muscle tone goes down very quickly without exercise,” Asada says.

The light-sensitive muscle tissue exhibits a wide range of motions, which may enable highly articulated, flexible robots — a goal the group is now working toward. One potential robotic device may involve endoscopy, a procedure in which a camera is threaded through the body to illuminate tissue or organs. Asada says a robot made of light-sensitive muscle may be small and nimble enough to navigate tight spaces — even within the body’s vasculature. While it will be some time before such a device can be engineered, Asada says the group’s results are a promising start.

“We can put 10 degrees of freedom in a limited space, less than one millimeter,” Asada says. “There’s no actuator that can do that kind of job right now.”

Rashid Bashir, a professor of electrical and computer engineering and bioengineering at the University of Illinois at Urbana-Champaign, says the group’s light-activated muscle may have multiple applications in robotics, medical devices, navigation and locomotion. He says exploring these applications would mean the researchers would first have to address a few hurdles. “Development of ways to increase the forces of contraction and being able to scale up the size of the muscle fibers would be very useful for future applications,” Bashir says.

In the meantime, there may be a more immediate application for both the engineered muscles and the microchip: Asada says the setup may be used to screen drugs for motor-related diseases. Scientists may grow light-sensitive muscle strips in multiple wells, and monitor their reaction — and the force of their contractions — in response to various drugs.

The other authors on the paper are Devin Neal, Yinqing Li and Ron Weiss from MIT, and Thomas Boudou and Michael Borochin from Penn.

This research was supported by the National Science Foundation, the National Institutes of Health, the RESBIO Technology Resource for Polymeric Biomaterials, the Center for Engineering Cells and Regeneration of the University of Pennsylvania, and the Singapore-MIT Alliance for Research and Technology.

Densely arrayed skeletal myotubes are activated individually and as a group using precise optical stimulation with high spatiotemporal resolution. Skeletal muscle myoblasts are genetically encoded to express light-activated cation channel, Channelrhodopsin-2, which allows for spatiotemporal coordination of the multitude of skeletal myotubes that contract in response to pulsed blue light. Furthermore, ensembles of mature functional 3D muscle microtissues have been formed from the optogenetically encoded myoblasts using a high-throughput device. The device, called “skeletal muscle on a chip”, not only provides the myoblasts with controlled stress and constraints necessary for muscle alignment, fusion and maturation, but also facilitates to measure forces and characterize the muscle tissue. We measured the specific static and dynamic stresses generated by the microtissues, and characterized the morphology and alignment of the myotubes within the constructs. The device allows for testing the effect of a wide range of parameters (cell source, matrix composition, microtissue geometry, auxotonic load, growth factors, and exercise) on the maturation, structure, and function of the engineered muscle tissues in a combinatorial manner. Our studies integrate tools from optogenetics and microelectromechanical systems (MEMS) technology with skeletal muscle tissue engineering to open up opportunities to generate soft robots actuated by multitude of spatiotemporally coordinated 3D skeletal muscle microtissues.

“The AFC-330 represents NIDEK’s 3rd generation of automated fundus camera. We are both proud and excited to be leading the way designing and producing fundus cameras that are faster, easier, and more versatile than ever. We anticipate increasing our fundus camera market share with our market expansion with MARCO Ophthalmic.”

Motoki Ozawa, President and CEO of NIDEK

“We couldn’t be more excited about adding the Nidek AFC-330 automated fundus camera to our full product line of diagnostic technologies. The AFC-330 fits perfectly into Marco’s successful model of increasing efficiency with the kind of powerful, easy-to-use, and high-quality instrumentation that our customers have come to expect.”

David Marco, President and CEO of MARCO

The AFC-330 makes quantum leaps improving the operator and patient interface, simplicity, automation, and total practice efficiencies. This camera offers an all in one compact design, auto alignment on the X-Y-Z axis, and a wide range of automated features including auto stereo for Glaucoma Management. The lower flash intensity and sound-dampening internal movements mean less retakes and improved patient comfort. No other Non-Mydriatic camera provides both this level of advanced automation and image quality.

While NIDEK will continue to sell to the Ophthalmology market in the United States, MARCO, the leader in Vision Diagnostics, will sell the NIDEK AFC-330 to the Optometry market. This market expansion is to increase the distribution channels and better serve new and existing customers for both companies.

About NIDEK:

Founded in Gamagori, Japan in 1971, NIDEK continues to be a global leader in research and development, design, manufacture and distribution of ophthalmic equipment. The United States subsidiary based in Silicon Valley, California, provides sales and service for ophthalmic lasers, refractive lasers, and many advanced diagnostic devices.

Founded in Jacksonville, FL, in 1967, MARCO continues to expand its position as ‘The Leader in Vision Diagnostics’ with a product line that encompasses classical lane equipment and NIDEK high-tech, automated refractive and retinal instrumentation. MARCO continues to provide unparalleled training and support to its expanding United States customer base.

The photo is also available at Newscom, www.newscom.com, and via AP Photo Express.

A new study conducted in an eye clinic in India found that correction of amblyopia, also called “lazy eye,” can be achieved in many older children, if they stick to a regimen that includes playing video games along with standard amblyopia treatment. Today at the 115th Annual Meeting of the American Academy of Ophthalmology, Dr. Somen Ghosh will report on the approaches that allowed about a third of his study participants, who were between 10 and 18 years old, to make significant vision gains.

By the end of the one year study, nearly 30 percent of the 100 participants achieved significant vision gains. About 60 percent showed at least some improvement. Significant gains were more likely in children who participated in Groups 3 or 4 of the four treatment regimens. Treatment Group 3 completed daily video game practice and Group 4 took the supplement citicoline, which is associated with improved brain function. Improvement was more likely in children younger than age 14 than in those 14 and older.

The prevailing wisdom has been that if amblyopia is not diagnosed and corrected before a child reaches school age, it is difficult or impossible to correct. But recently the United States-based Pediatric Eye Disease Investigation Group (PEDIG) reported significant vision gains in 27 percent of older children in a study funded by the National Eye Institute. This report motivated Dr. Ghosh to test new approaches to learn what might be particularly effective in this age group.

His study was divided into four treatment groups. Students in all groups followed a basic treatment plan that required them to wear eyeglasses that blocked the stronger eye for at least two hours a day, during which time they practiced exercises using the weaker eye. This “patching” technique is a standard amblyopia treatment that works by making the weaker eye work harder. Group one followed only the basic plan and served as the control group, while groups two, three and four received additional treatments:

Group 2 took a supplement that contained micronutrients considered important to good vision

Group 3 played at least one hour of video games daily using only the weaker eye

Group 4 took the supplement citicoline, which is associated with improved brain function

Saurav Sen, a 16 year old graduate of Dr. Ghosh’s clinic, received a second chance to achieve good vision. At age 13 Sen began to experience serious vision problems, which negatively impacted his school work. Other doctors had told him it was too late to correct his amblyopia. He completed the regimen assigned to treatment Group 3.t

“Playing the shooting games while using just my weaker eye was hard at first, but after a few months I could win all game levels easily,” said Sen. “I’m very happy that I stuck with the program. My vision has improved a lot, so that I now have no trouble studying or taking exams. My tennis game also improved, and of course I’m now a pro PC gamer.”

“The cooperation of the patient is very important, maybe even crucial, to successful treatment of amblyopia,” said Dr. Ghosh. “We should never give up on our patients, even the older children, but instead offer them hope and treatment designed to help them achieve better vision.”

Purpose:

To know the efficacy of treatment for amblyopia in an older age group.

Methods:

100 patients were selected of an age group from 10 -18 years and divided into 4 groups: Group I: general protocol (GP), occlusion, orthoptic exercises; Group II: GP + antioxidant tablets; Group III: GP + stimulating video games (shooting games, car racing 2 hours/day); and Group IV: GP + Tab Citicoline 500 mg b.i.d. for 3 months, then tapering dose. Minimum follow-up period was 2 years

Results:

Visual acuity improvement of Group I (52%) and II (56%) were similar; Group III (64%) and IV (72%) showed better result. The improvement decreased with increasing age.

Conclusion:

With a proper management plan for amblyopia; improvement in visual acuity and binocular function for patients in an older age group can be achieved.

Zero-dilation EasyScan solution now available in Europe with USA to follow soon

A new, hi-tech retinal imaging solution that can help millions of diabetes patients from going blind has been released in Europe[1]. The groundbreaking system, called EasyScan, has been developed by i-Optics, a specialist eye diagnostics company that is pioneering innovative retina and cornea imaging systems.

Validated with specialists at the Netherlands’ Rotterdam Eye Hospital, EasyScan is a fast and easy-to-use non-mydriatic retinal imaging system that uses advanced Scanning Laser Ophthalmoscope (SLO) technology. In addition, EasyScan is less expensive and more portable than the systems currently employed for retinal imaging, so bringing high-end eye-care within reach of far more eye specialists – and their patients. This is good news for diabetes patients everywhere. Early diagnosis and timely treatment are crucial to preventing blindness among the more than 300 million diabetes sufferers worldwide. “With aging populations and growing obesity, countries everywhere face a rapid increase in diabetic retinopathy, age-related macular degeneration, glaucoma, and other retinal diseases,” said Jeroen Cammeraat, CEO at i-Optics. “Unfortunately, the traditional fundus cameras used to diagnose these conditions are large, exclusive, and expensive, as well as being slow and difficult to use. EasyScan has been designed from the ground up to solve all these problems.”

EasyScan offers a number of benefits over fundus cameras: it is fast, easy-to-use, patient friendly and accessible. Weighing less than 7kg and with a footprint smaller than a binder, EasyScan is extremely portable – which means imaging can be brought closer to the patient. It consumes little power and it connects to a PC or laptop via a standard USB connection. EasyScan is based on SLO technology, which brings out clinical features in the retina in the earliest stages, provides better contrast than fundus cameras, and can better penetrate media opacities such as cataract and corneal opacities.

Because pupil dilation is not required – as a confocal camera, EasyScan can image through pupils as small as 2mm – using EasyScan reduces the patient’s waiting time by at least 30 minutes. Patients can also drive home immediately after being examined. Scanning also takes significantly less time. Internal fixation lights, for example, guide the patient’s gaze, enabling the operator to image both the central and nasal field quickly and comfortably. Other time-saving benefits include live image previewing with the option to freeze the image on your computer screen, self-guiding software that eliminates the multitude of settings and controls required by fundus cameras, and automatic focusing. “Add in a full digital workflow for storing, retrieving, archiving and sharing images instantly, and immediate plug-and-play connectivity, and EasyScan truly can be used by anyone, anywhere,” said Cammeraat.